颅脑火器伤四例救治体会  

Surgical treatment of craniocerebral firearm injury with clinical anlysis of 4 cases

作　　者：陈宇晖 望家兴 田君 魏梁锋 王守森 Chen Yuhui;Wang Jiaxing;Tian Jun;Wei Liangfeng;Wang Shousen(Department of Neurosurgery,the 900^(th)Hospital of Joint Logistics Team,Fuzhou 350025,China;Department of Neurosurgery,The First Hospital of Yichang,Yichang 443099,China)

机构地区：[1]联勤保障部队第九〇〇医院神经外科,福州350025 [2]宜昌市第一人民医院神经外科,443099

出　　处：《中华神经创伤外科电子杂志》2022年第1期47-50,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：联勤保障部队第九〇〇医院院内课题(2020Z04)。

摘　　要：目的探讨颅脑火器伤(CFI)的救治策略和效果。方法选取联勤保障部队第九〇〇医院神经外科自2018年1月至2021年12月收治的4例CFI患者为研究对象,回顾性分析患者的临床资料,采用GOS评分评估患者的预后。结果所有患者均接受及时开颅清创手术和术后综合治疗。存活3例,其中1例术后左上肢肌力3级,左下肢肌力1级,右侧肌力正常;另2例患者恢复良好,其中1例留有轻微精神症状,1例随访期间无并发症及神经功能障碍。死亡1例,于术后2年因肺部感染、急性肾衰而死亡。结论CFI病情凶险,院前急救能为手术赢得先机,恰当的手术处理能增加生存概率,围术期管理有助于提高生存质量。Objective To investigate the treatment strategy and effect of craniocerebral firearm injury(CFI).Methods A total of 4 patients with CFI admitted to Neurosurgery Department of the 900th Hospital of Joint Logistics Team from January 2018 to December 2021 were selected.The clinical data of patients were analyzed retrospectively,and the prognosis of patients was evaluated by GOS score.Results All patients underwent craniotomy debridement and postoperative comprehensive treatment,3 patients survived,1 patient had left upper limb muscle strength grade 3,left lower limb muscle strength grade 1,and normal muscle strength of right side;2 patients recovered well,1 patient had mild psychiatric symptoms,and 1 patient had no complications and neurological dysfunction during follow-up.One patient died due to pulmonary infection and acute renal failure 2 years after operation.Conclusion The condition of CFI is dangerous,prehospital emergency can win the opportunity for surgery,and appropriate surgical treatment can increase the probability of survival,perioperative management can help to improve the quality of survival.

关 键 词：颅脑损伤 火器伤 外科救治 损伤控制性手术 

分 类 号：R826.5[医药卫生—临床医学]